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Most common type of bacterial disease and 2nd most common type
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UTI risk factors
- Improper handwashing & caths
- DM, females, older age, Cr. >2.0
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Source of UTI's
- Ascending route infections
- GN bacilli, some gram +
- Urologic instruments
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Classification of UTI's
- Upper-Pyelo
- Lower-Cystitis
- Comp vs. Uncomp
- Relapse vs. reinfection
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Pyelo vs. UTI Symptoms
Pyelo= presence of fever, flank pain, CVA tenderness, N/V
UTI= freq., urgency, may have suprapubic pain, dysuria, maladorous urine, pyuria
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Treatment
- Resistance patterns
- vary geographically. In US >25% of E.coli strains are resistant to amoxicillin, sulfa drugs, cephalexin
- Uncomplicated
- cystitis can be routinely treated with a 3 day course of Septra/ Bactrim (95% effective in
- most cases)
Also consider flouroquinolones
Cephalosporins
Pyridium (analgesic effect)
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Chronic Pyelonephritis
- Aka :chronic
- interstitial nephritis
- Usually the end
- result of long standing UTIs
- Chronic inflammation
- and scarring of the kidneys
- IVP, renal biopsy,
- renal u/s or CT may be useful
- in delineating the severity
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